NPI | 1386467736 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY ADAMS Medical Clinic Coordinator 920-425-4140 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2024-11-04 |
Last Update Date | 2024-11-12 |